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Introduction to Global Mental Health

South Africa Travel blog

Mathilde and Ann Elise are both part of the master’s program Global Development Theory and practice at the University of Bergen. This semester they have been part of the Global Mental Health Introduction and Practicum along with clinical psychology students from Norway, Nepal and Vietnam. This is a program run by the Center for Crisis Psychology for clinical psychology students, and it is the first time students from a different program has been invited to take part. This is their experience:

Workshop
Photo:
Jacob Mhlapeng

Main content

Introduction course in Mental Health

Good health and well-being is one of the 17 Sustainable Development Goals (SDGs), and mental health an important part of this. The SDGs were made by UN as a global strategy for achieving peace and prosperity for all and is a key point when talking about development locally and globally.

Ann Elise is doing a specialization in Health Promotion and Mathilde is doing her specialization in Gender in Global Development. Though we are not Psychology students it was clear that Global mental health is highly relevant for both of these specializations, and that we could bring in important insights from our field of study. 

This fall we got to join a group of psychology students and Ph. D. candidates from Nepal, Vietnam and Norway in a course about global mental health. As students coming from the field of Global Development, it has been very interesting to take part in lectures and group projects with competent and experienced people from all over the world.

Why mental health is important

According to the WHO, mental health conditions has increased 13% in a decade (by 2017). Depression and anxiety alone cost the global economy US$ 1 trillion each year. 20% of children and youth suffer from mental health condition and bad mental health reduces life-expectancy with 10-20 years. It causes 1 of 5 years lived with disability, and mental health has a huge impact on both the person in question and the people around.

It is no question mental health is a social issue to be reckoned with, but only 10-25% of mental health conditions are being treated. This means the majority of people do not receive any help. People in survival mode - whether we are talking about severe feelings of hopelessness or anxiety, poverty, or escaping extremities of war or nature disaster - will mainly be concerned about making it through another day.

It will be hard talking about climate crisis, quality education, clean energy, responsible consumption and production, etc., with someone who don’t know if they will survive until the sun rises, or whether they actually want to. Promoting mental health is crucial in reaching SDG 3, but also for progressing in the other Sustainable Development Goals as they are all interlinked.

Health Promotion is guided by the WHO Ottawa Charter which defines health as concerning both caring for oneself and others, being in control of own’s life and decisions, and creating societal conditions that promote health for all. Mental health is an important part of caring for oneself and being well, but possessing good mental health is also important for making good and right decisions, and contributing to a society with conditions promoting health.

It is also relevant to look at how gender and gender stereotypes can contribute to people’s mental health. For example, feeling pressured by society to conform to an identity that you cannot identify with can lead to major mental issues. If one does identify within a given gender, it might be a lot of pressure to live up to the ideals for the gender, e.g., as a bread winner for men, or as stay-at-home-moms for women. Feeling that you cannot live up to these expectations can lead to MH issues as well, and it is therefore crucial to look into the causes of such issues.

Going To South Africa

As the clinical psychologist students moved on with the next course, we - the development students - left for Johannesburg in South Africa to do an 8-week internship at Field Band Foundation (FBF).

Field Band Foundation is a non-profit organization using musicking to create ‘empowered and healthy young people able to contribute to a vibrant society’. Youth in areas at social risk are trained in playing musical instruments and dancing, so that they can enjoy music with others, express emotions in healthy ways. Thereby, they are able to increase their confidence, discipline, healthy self-expression and coping mechanisms through developing their skills in music and dance. As part of the rehearsals, the members are also given sessions on different life skills and social inclusion to set them up for a better future, so that they can contribute to a more inclusive society.

During our 8 weeks at the Head Office in Johannesburg we have done a lot of different things.

We have gotten to take part workshops with tutors from different bands, leading sessions on work readiness. In these sessions we teach the tutors about writing CVs and Motivational letters, give them feedback on their own CVs and Motivational letters, and discuss important teacher and learner traits. This is important both to improve their skills as tutors, but also to set them up for success in applying for jobs after their time in FBF.

We have been developing content for life skills lessons on Mental Health and Domestic violence to be given to the children and teenagers. The life skill sessions are an important part of the band rehearsals to promote well-being, resilience and inclusiveness in and among the members, and for them to go out and make an impact in their communities.

We have been introduced to M&E (monitoring and evaluation) used in the organization, been sitting in on an endless number of meetings, and eaten a whole lot of the local vetkoeks. (Balls of deep-fried sweet dough. Very tasty!)

We’ve also been visiting bands in some of the poorest areas of the city watching incredible music and dance performances by youth that is clearly loving what they are doing, and we have gotten to talk to so many of the staff possessing a great love for their work and for the members of the bands. We have so many new heroes added to our list of people really trying to make a change in their societies. And next to all of this, we have learned how to survive in one of the most dangerous cities in the world.

Coming from Norway - the best country to live in according to the UN Development Report of 2022, and on top 20 safest countries according to the Global peace index - it is a quite a change of mindset entering a place where you need to keep your car doors locked at all times and not stop at red lights after 9 in the evening due to risk of being robbed of high jacked. It is strange living in gated communities, with guards checking everyone coming in and out, needing to be very careful with what neighborhood you go to, not walk outside the gate after sunset, constantly watch your stuff, and be aware of the crazy taxi drivers. And these are just some of the safety measures.

In the very beginning we were given driving lessons for learning to drive on the left side of the road, not the right, so that we could drive back and forth from work. The lessons were also for us to learn how to survive in the South African traffic which seems like complete chaos at first. But believe me, there is a system. And once you crack the code, you feel like you can survive anything.

We’ve had to get accustomed to tip everyone everywhere; the waiters, the guys helping us find a parking place and watching our car, the guys filling petrol at the gas stations, the guy cleaning your windshield at the street lights even though you did not ask for it, the guys running over with parasols when it is raining, and more.

We’ve had to get used to pretending to always be doing fine. Cause ‘How are you’ is not really the question, it’s just a way of greeting. Even at the pharmacy being sick with infections and fever, you are always ‘doing good’. We’ve also had isizulu lessons as part of getting to know the culture. It is one of the 11 official languages, and one containing clicking sounds - please do not ask for demonstrations. Luckily, we will be able to greet you without any further embarrassment.

In the organization there were also other Norwegians doing an exchange program. Interestingly, some of the Norwegians found that living in a surrounding with heightened risk for ourselves and our belongings, and meeting people where poverty and violence is part of their lived reality, led to a slight change of humor. Like it grew a bit ‘darker’ as to accommodate for keeping mentally stable in a surrounding different from home.

Learning to survive and thrive in a new culture where people act, think and speak differently takes time and requires a lot of attention and energy. Integration is hard work. This is also next to adjusting to a new work environment and work tasks. At the end we did survive, and even though it has been challenging at times, the overall experience has been amazing. We are leaving this place with a gratitude of all we have seen, experienced, learned and the people we’ve gotten to know along the way. It is truly a beautiful place full of beautiful people. Field Band Foundation is doing an amazing job giving children and youth and opportunity for a better life in some very poor areas, and it has been an honor to take part of this for a shorter period.